Living Well with Dementia through Music

To celebrate World Book Day the Music for Dementia Team were lucky enough to catch up with the brilliant Catherine Richards a Music Therapist and proud Editor of the fabulous book “Living Well with Dementia through Music” A Resource Book for Activities Providers and Care Staff

Here’s what we found out………

Tell us about the book?
Music is an essential tool in dementia care. This book embraces ways in which music can enhance the daily lives of those with dementia. It draws on the expertise of practitioners regularly working in dementia settings, as well as incorporating research on the benefits of music for people living with dementia to help anyone, whether or not they have any musical skills or experience, to successfully use music in dementia care. Guiding the reader through accessible activities with singing, percussion, sounding bowls and other musical tools, the book shows how music can be used from the early to late stages of dementia. This creative outlet can extend to inspire dance, movement, poetry and imagery. The chapters include creative uses of technology, such as tablets and personal playlists. The book also covers general considerations for using music with people living with dementia in institutional settings, including evaluating and recording outcomes. Living Well with Dementia through Music is the perfect go-to guide for music-based activities with people living with dementia.

When did you start working with people with dementia?
I qualified as a Music Therapist in 1991, and my first job was at Friern Hospital in North London.  Part of my role was working on Elderly Mentally Ill (EMI) wards, as they were called then.  I was struck by the way in which people in very late stages of dementia were still able to respond to singing and music-making.  Two incidents I still remember involve women who seemed to find ways to show their appreciation for the music days before they died – one by saying: “Thank you – I enjoyed that very much” very clearly when I had not heard her speak for some time, and another by joining in enthusiastically with all the songs when she had not actively participated for a number of weeks.

From 1994 – 2008, the majority of my work was with adults with learning disabilities, and then I returned to work with older adults in my current role as music therapist for Kent and Medway NHS and Social Care Partnership Trust.

I especially enjoy my work with people living with dementia as it is very rewarding to see people experiencing joy and laughter, as well as shedding a few tears sometimes, even though they are living with such a challenging condition.  I enjoy the way in which people who are often isolated can come together in a group with others, and the way people are able to demonstrate that their long-term memory which recalls song tunes and lyrics, and their sense of rhythm and general musicality, is still intact.  And also the way in which personalised music can bring back a person’s memories and sense of self, which they can then recall and share with relatives and those involved in their care.

Have you seen the profile of music for dementia change over time and what do you think is influencing that?
I remember a session during my time at Friern in the early ‘90s when I was trying to engage a small group in music-making when a domestic worker began vacuuming right next to us. I turned to her and said: “It’s a bit noisy”.  She replied: “Oh no it’s fine – I like a bit of music while I’m working”. Even years later, when I first began working at KMPT in 2008, I remember arriving on a ward and telling a member of staff that I had come to make some music with the patients.  She looked at me incredulously and said: “You’re what??”   Now, 12 years later, music therapy groups are seen as an important part of patient care on the ward, with staff and relatives joining in and helping to support patients in singing, playing instruments and reminiscing.  Although we still have a long way to go before all people living with dementia have the opportunity to gain the maximum possible benefits from the role music could play in their day-to-day care, I feel it is important to celebrate the achievements that have been made.

I think the positive changes in the profile of music for dementia have come about due to a variety of different factors – music therapists and music practitioners working on wards and care homes over a number of years and staff, relatives and managers witnessing the results; evaluations and research into the benefits of music with people living with dementia and those who care for them; the growth of networks and conferences where practitioners using music in this field can share ideas and experiences and support each other; TV programmes such as the Dementia Choir with Vicky Maclure; social media, ie the clip of Henry in “Alive Inside”, which has been viewed by millions; the launch of the report commissioned by the Utley Foundation: “Without a Song or a dance what are we?”; and, of course, the campaign Music for Dementia

Why did you write the book?
The book came about because I sent Jessica Kingsley Publishers a copy of a song-book I had put together with psychology students on placement with me at KMPT.  This has a number of features I find especially useful in work with people living with dementia, and I wondered if JKP would be interested in publishing it.  They declined as they felt it would be unlikely to sell, however they felt there was a gap in the market for a book demonstrating different ways of using music for those caring for people living with dementia, where no formal musical skills are required. I was asked if I would be interested in putting together a proposal.  I was unsure at first but took the idea to the next British Association of Music Therapists (BAMT) Dementia Network meeting.  Those attending were very encouraging, giving me some useful ideas, and some agreed to contribute.

It was exciting thinking of all the different ways in which music could be used in dementia care and finding experts in that area to write about them.  Some contributors wrote about ways of using music which were completely new to me, and I have now begun some freelance work at Age UK incorporating some of the ideas in the chapters by Music Therapists Alison Acton and Harriet Powell around combining music with visual imagery and poetry, and making albums containing the lyrics of people’s favourite songs.

What can people do today if they want to help make music a part of someone’s dementia care?
There are so many different ways of using music, and it’s important to find ones that suit the needs and preferences of both you as the caregiver and the person you are caring for. In the book there are chapters on singing, using technology, using percussion instruments, sound therapy, playlists, records, movement, and using music to inspire imagery and poetry, and to encourage increased co-operation in personal care.

Here are some tips:

  1. Think about which of these you enjoy and would feel most comfortable using, and take the time to explore a little by yourself first before introducing any new ideas to someone else. If you feel confident and relaxed, the person you are caring for is more likely to be receptive to the intervention.
  2. Think about how you are going to use an intervention to meet the needs of the person you are caring for.  For example, there are several reasons why you might want to use music as a means of encouraging dance/movement: to maintain physical fitness and well-being, and movement in limbs, joints and fingers etc; to engage someone and help to lift their mood as it is an activity they enjoy; and/or to encourage reminiscence and rekindle affection for a partner, remembering times when they used to dance to music earlier in the relationship.  There is a chapter in the book about using music to inspire movement and dance by Dance/Movement therapist Nicola Jacobson-Wright.
  3. Be prepared to try new things, and for the possibility that something might not work to begin with.  If the person is giving clear signs of displeasure, just stop, and think about the possible reasons for their negative response – talk with them about this if possible.  It may be that they have something else on their mind, that they were hungry, needed the toilet or were feeling unwell, and that they might respond better another time. They may not feel comfortable in that particular space, and respond better in another room.  Someone I am currently working with gets cross when I come onto the ward and refuses to join in with the music, but thoroughly enjoys coming to another group I run in a different building.  It may be that they need time to get used to something new, and can only manage a short amount of time to begin with.  Or it may be that they just don’t like that particular intervention, and that you need to try something else.  Trial and error is key, and you will be learning all the time.
  4. Be prepared to be flexible, and for benefits to be gained from introducing music into the care of someone living with dementia that you didn’t expect!

And lastly tell us what would be on your personal playlist?
It would be difficult for me to commit to one playlist as there are so many songs/pieces of music that I have played, listened to or danced to at different periods of my life.  Some that come to mind are:

Mozart bassoon concerto in B flat
Chopin Mazurka in A minor
Bohemian Rhapsody – Queen
You’re the one that I want – from Grease
Hopelessly Devoted to You – from Grease
Brass in Pocket – The Pretenders
Jilted John – Jilted John
Fernando – Abba
I just want to make love to you – Etta James
Into the Mystic – Van Morrison
My Baby Just Cares for Me – Nina Simone
Smooth Operator – Sade
Careless Whispers – George Michael
I Don’t know how to Love Him – Jesus Christ Superstar
Hit me with your Rhythm Stick – Ian Dury and the Blockheads
Lost in Music – Sister Sledge
Dry Land – Joan Armatrading
The Sidewinder – Lee Morgan

The book is out now and is available from all good book shops.